Course Content
Module 1: Basic ECMO
Module I: Extracorporeal Membrane Oxygenation Basics (ECMO Basics) This module covers the foundational knowledge of ECMO, including circuit physiology, components, and basic ECMO management. Duration: 3 Weeks (Course weeks 1 to 3) Week 1: Introduction to ECMO Week 2: ECMO Physiology & Circuit Management Week 3: ECMO Complications and Troubleshooting Module I Pretest: 30 MCQs
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Module II: Veno-venous Extracorporeal Membrane Oxygenation (VV ECMO)
This module focuses on the use of VV ECMO in patients with respiratory failure. Topics include ARDS management, VV ECMO cannulation strategies, and VV ECMO troubleshooting. Duration: 3 Weeks (Course weeks 4 to 6) Module II Pretest: 30 MCQs Week 4: VV ECMO Fundamentals Start Date: July 20, 2025 a. Respiratory failure and ARDS management (Ahmed Magdey) b. Evidence for VV ECMO use and landmark trials (Hesham Faisal) c. VV ECMO cannulation techniques and pros and cons of different VV ECMO configuration choices (Moustafa Esam) d. ECMO Retrieval and Patient Transport on ECMO (Ahmed Labib)
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Module III: Veno-arterial Extracorporeal Membrane Oxygenation (VA ECMO)
This module focuses on VA ECMO for cardiogenic shock, including cannulation strategies, LV unloading, and advanced applications. Duration: 3 Weeks (Course weeks 7 to 9) Module II Pretest: 30 MCQs
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Extra Corporeal Membrane Oxygenation (ECMO) and Mechanical Circulatory Support (MCS) course (Copy 4)

🔹 Webinar Focus: Oxygenator Failure & Crisis Management

  • Analogy: Treat oxygenator failure like cardiac arrest – act fast.

  • Failure signs:

    • Drop in SpOâ‚‚ and MAP, increased agitation.

    • Dark return blood, rising delta pressure (pre/post membrane).

  • Diagnosed using:

    • Blood gases (low PaOâ‚‚, high PaCOâ‚‚, acidosis).

    • Pressure gradients (pre/post membrane).

    • Biochemical markers (↑free Hb, LDH; ↓platelets, fibrinogen).

🔹 Management Protocol

  • Prioritize systemic oxygen delivery before oxygenator exchange.

  • Initiate exchange protocol: ventilator support may be temporarily increased.

  • Ensure clear role delegation among team members:

    • ECMO specialist: Prepare circuit.

    • ICU nurse: Monitor/support patient.

    • Intensivist: Lead, coordinate.

    • Perfusionist: Assist circuit exchange.

  • Team debriefing post-event is critical for improvement and safety.

🔹 MCQ Highlights

  • Dark return blood is the early warning sign of oxygenator failure.

  • Most reliable indicator: rising pre/post membrane pressure gradient.

  • Key action before exchange: call for emergency change, not reduce pump speed.

  • After exchange: document, debrief, and analyze system/process.

🔹 Additional Key Points

    • Acute deterioration → Immediate action.

    • Gradual dysfunction → MDT discussion.

      Crisis vs. elective oxygenator exchange:

  • VV ECMO patients can tolerate longer periods without anticoagulation.

  • Circuit changes may carry risks; balance decisions with clinical context.

  • Oxygenator failure causes:

    • Thrombosis (most common), plasma leak, sweep gas issues.

🔹 Educational Emphasis

  • Simulation-based training is essential (like ACLS, PALS).

  • Ongoing education, protocols, drills, and crisis preparedness must be embedded in practice.

  • Future sessions will include realistic simulation training to improve crisis response.

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